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Publications

Journal Article Ahead of print

PubMed: 41736503 DOI: 10.1093/eurheartj/ehaf1074

Outcomes of heart failure with reduced, mildly reduced, or preserved ejection fraction: the ESC HF III registry.

Eur Heart J

Authors: Lars H Lund, Aldo P Maggioni, Maria G Crespo-Leiro, Cecile Laroche, Israel Gotsman, Belma Pojskic, Eleonora B Vataman, Lucica Grigorica, Hamayak Sisakian, Duska Glavas, Dulce A Brito, Stefan Anker, Ovidiu Chioncel, Gerasimos Filippatos, Mitja Lainscak, Theresa A McDonagh, Alexandre Mebazaa, Massimo Piepoli, Frank Ruschitzka, Gianluigi Savarese, Petar M Seferović, Marco Metra, Giuseppe Rosano

Affiliations

  • Department of Cardiology, Karolinska Institutet, Norrbacka, S1:02, 17176 Stockholm, Sweden.
  • ANMCO Research Center, Heart Care Foundation, Florence, Italy.
  • Department of Cardiology, Hospital Universitario A Coruña (CHUAC), Cardiology, INIBIC (Institute Investigacion Biomedica A Coruña), A Coruña, Spain.
  • Department of Cardiology, CIBERCV, A Coruna, Spain.
  • Department of Cardiology, Universidad de A Coruña (UDC), A Coruna, Spain.
  • European Society of Cardiology, Sophia-Antipolis, France.
  • Hadassah University Hospital, Jerusalem, Israel.
  • Cantonal Hospital Zenica, Medical Faculty University of Zenica, Zenica, Bosnia and Herzegovina.
  • Heart Failure and Cardiac Rehabilitation, Institute of Cardiology, Chisinau, Republic of Moldova.
  • Department of Cardiology, Emergency Hospital 'SF Apostol Andrei' Galati, Galati, Romania.
  • Head of Clinic of General and Invasive Cardiology, University Hospital 1, Yerevan State Medical University, Yerevan, Armenia.
  • Department of Cardiovascular Disease, Intensive Care Unit, University Hospital Split, Split, Croatia.
  • Heart and Vessels, Cardiology, ULS Santa Maria, Hospital Universitário, Lisboa, Portugal.
  • Centro Cardiovascular da Universidade de Lisboa, CCUL@RISE, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
  • Department of Cardiology (CVK) of German Heart Center Charité, German Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charité Universitätsmedizin, Berlin, Germany.
  • Department of Cardiology, University of Medicine Carol Davila, Bucharest, Romania.
  • Department of Cardiology, Athens University Hospital Attikon, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
  • Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
  • Division of Cardiology, General Hospital Murska Sobota, Murska Sobota, Slovenia.
  • Department of Cardiology, King's College Hospital, London, UK.
  • Université Paris Cité, MASCOT Inserm Unit, Hôpitaux Universitaires Saint Louis et Lariboisière, APHP, Paris, France.
  • University Cardiology, IRCCS Policlinico S Donato, Via Morandi 30, 20130 San Donato Milanese, Milan, Italy.
  • Department of Cardiology, University Heart Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
  • Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
  • Department of Clinical Science and Education, Södersjukjuset, Karolinska Institutet, Stockholm, Sweden.
  • Serbian Academy of Sciences and Arts, Belgrade, Serbia.
  • Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Cardiology, Brescia, Italy.
  • Department of Human Sciences and Promotion of Quality of Life, San Raffaele Open University of Rome, Rome, Italy.
  • Department of Cardiology, San Raffaele Cassino Hospital, Cassino, Italy.

Abstract

BACKGROUND AND AIMS

To assess in-hospital and 1-year cause-specific outcomes in the contemporary European Society of Cardiology (ESC) Heart Failure (HF) III Registry.

METHODS

Patients were enrolled in European or ESC affiliated countries and characterized in detail regarding clinical characteristics and cause-specific outcomes.

RESULTS

Between 1 November 2018 and 31 December 2020, 10,162 patients were enrolled from 220 centres in 41 countries. Of these, 39% had acute HF ('AHF', age 70 [62-79] years, 36% women) and 61% had out-patient visit for HF ['out-patient HF', age 66 (58-75) years, 33% women]. Overall, 58% had HF with reduced ejection fraction (HFrEF), 17% HF with mildly reduced ejection fraction (HFmrEF), and 25% HF with preserved ejection fraction (HFpEF). In AHF, median [interquartile range (IQR)] duration of hospitalization was 9 (6-14) days, and 5.1% died in hospital (HFrEF 5.2%; HFmrEF 4.8%, HFpEF 3.4%). In AHF discharged alive and in out-patient HF, after a median (IQR) follow-up of 376 (360-432) days, all-cause, cardiovascular (CV), and unknown-cause mortality rates per 100 patient-years were as follows: AHF HFrEF: 19, 13, and 3.0 per 100 patient-years. The corresponding numbers were in AHF HFmrEF: 22, 11, and 6.3; AHF HFpEF: 16, 7.0, and 4.7; out-patient HFrEF: 6.6, 4.3, and 0.9; out-patient HFmrEF: 4.0, 2.6, and 0.8; out-patient HFpEF: 3.9, 1.7, and 1.2. At least one (re-)hospitalization for HF was experienced in 44% AHF HFrEF, 42% AHF HFmrEF, 36% AHF HFpEF, 21% out-patient HFrEF, 14% out-patient HFmrEF, and 18% out-patient HFpEF.

CONCLUSIONS

In HF in Europe and affiliated countries, in-hospital mortality was 5.1% and greater with lower ejection fraction. Among hospital survivors and out-patients over 1 year of follow-up, event rates per 100 patient-years varied for death, 3.9-22, CV death 1.7-13, and unknown cause of death 0.8-6.3. The percent of patients that were (re-)hospitalized for HF at least once over 1-year follow-up ranged 14-44% and was twice as high post-AHF compared with post-out-patient visit.

MeSH

Registries, Mortality, Hospitalization, Heart Failure, Heart, Heart Failure, Diastolic, Hospital Mortality, Cardiology, Heart Failure, Systolic, Outpatients